JP2016538011A - Catheter advancement device - Google Patents

Abstract

A catheter advancement device that allows a surgeon to operate a catheter with one hand to advance the catheter. A catheter advancement device includes a catheter inlet, a catheter outlet, and a manually operated finger operated drive mechanism. The drive mechanism is configured to frictionally engage a catheter inserted into the inlet and advance the catheter through the housing to move it into and out of other devices such as a needle. The housing may be slidable along the needle. [Selection] Figure 1

Description

  The present invention relates generally to the field of medical catheters, and more particularly to a device for advancing a catheter into a patient through a needle or other tubular device.

  Ultrasound imaging of needle placement in various medical procedures is particularly well known for peripheral nerve blocks in which medication is delivered through a catheter to a target site within a patient. For such procedures, an ultrasound probe is used to identify the target area and provide an image of advancement of the needle to the target area. Once the placement of the needle tip within the target area is confirmed, the medication can be delivered through the needle. In certain procedures that require prolonged or continuous drug delivery, the surgeon advances the infusion catheter through the needle so that the tip of the catheter is also placed in the target area. The needle can then be removed and drug delivery can begin through the catheter.

  A disadvantage associated with conventional ultrasound imaging systems and procedures is that the surgeon typically uses one hand to hold and manipulate the ultrasound probe relative to the patient and the other hand to target the needle. It is a point that will be guided to. Once the needle tip is placed in the target area and confirmed, the surgeon must hold the needle as stationary as possible. An assistant other than the surgeon must use a delivery device (eg, a syringe) to inject medication through the needle or to insert a catheter through the needle, while the surgeon holds the needle stationary. The ultrasonic probe will be controlled. This procedure is cumbersome and cumbersome and requires a plurality of people.

  Devices have been proposed to assist the surgeon by locking or immobilizing the needle relative to the ultrasound probe. For example, US Patent Application Publication No. 2010/0041990 published on February 18, 2010 (Patent Document 1), US Patent Application Publication No. 2010/0312121 published on December 9, 2010 (Patent Document 2). ), And International Publication No. 2013/019806 published on February 7, 2013 (Patent Document 3). However, these devices can cause problems in certain procedures in that they do not allow independent control and manipulation of needles that are remote from the location of the ultrasound probe.

US Patent Application Publication No. 2010/0041990 US Patent Application Publication No. 2010/0312121 International Publication No. 2013/019806

  There is a need for a device that allows the surgeon to hold the introducer needle stationary in the target area at one hand and away from the ultrasound probe while at the same time allowing the catheter to be advanced through the needle. ing. The present invention provides such a device.

  Some of the objects and advantages of the present invention will be specifically described below. However, there are parts that are obvious from the description or can be understood through practice of the present invention.

  In certain aspects, the present invention relates to a unique catheter advancement device that is particularly useful in nerve block procedures. The device comprises a housing having a catheter inlet and a catheter outlet, and a catheter, such as an infusion catheter, is passed through the inlet, through the housing, and out of the outlet. A manually operated finger operated drive mechanism is provided between the catheter inlet and the catheter outlet. This drive mechanism frictionally engages the catheter inserted through the housing, and the clinician manipulates the drive mechanism with one finger (which may be the clinician's thumb) to move the catheter in either direction through the housing. To be able to move forward.

  In particularly useful embodiments, the housing further comprises a needle channel configured to pass a needle, such as an introducer needle, and a locking mechanism. The housing is slidable along the needle after the needle is inserted into the channel, and the housing can be locked in a fixed relative position on the needle by a locking mechanism. In this configuration, the clinician can place the device in a fixed position on the introducer needle and manipulate the needle with one hand to keep it stationary while simultaneously advancing the catheter through the needle with the same hand.

  It should be understood that the channel can be defined at any suitable location on the housing depending on the shape and size of the housing. In certain embodiments, the needle channel is defined by a pipe-like structure along the edge of the housing.

  The locking mechanism is any suitable mechanical or friction brake type lock that acts to secure the housing in a fixed position along the needle, at least to prevent inadvertent or unintentional slipping of the housing needle. possible. For example, the lock can be a simple set screw that engages the needle when fastened. In certain embodiments, the locking mechanism includes a biased arm or lever that extends into the channel and frictionally engages the needle with sufficient force to prevent unintentional slipping of the housing against the needle.

  The drive mechanism operated with a finger can be of various different configurations. In certain embodiments, the drive mechanism includes a catheter in a nip defined between a drive wheel that is a finger-operated drive wheel and an opposing surface that is, for example, an idler wheel or other support surface. It can be a nip drive that is inserted. For example, in certain embodiments, the housing may include a front panel member and an opposite rear panel member, the front and rear panel members each extending in a plane parallel to each other. The nip drive unit includes a drive wheel and an idler wheel disposed between the front panel member and the rear panel member, and these wheels are disposed on a common plane, and the front panel member and the rear panel member are Has a vertical axis of rotation. This configuration provides a thin, compact and efficient design that is easily manipulated and controlled by the clinician.

  The drive unit may also include a first external finger operation plate attached to the drive wheel and extending from one of the front panel member and the rear panel member for manual operation outside the drive wheel. In a further embodiment, a second external finger manipulation plate is attached to the drive wheel on the opposite side of the housing from the first external finger manipulation plate and the housing is substantially sandwiched between the two finger manipulation plates. Configured as follows. In this embodiment, the drive wheel can be controlled from either side of the housing. One or both of the finger-operating plates extend radially beyond the edge of the housing, and the clinician also has the option of controlling the drive wheel by moving the finger along the edge of the housing Can be even more beneficial.

  In yet another embodiment, the drive wheel and idler wheel may be configured to be disposed at least partially inside the parallel front panel member and rear panel member and have a rotational axis parallel to both panel members. The outer peripheral portion of the drive wheel extends to the outside through the front panel member or the rear panel member for manual operation of the drive wheel. The outer peripheral portion of each of the drive wheel and idle wheel may extend to the outside via one of the front panel member and the rear panel member, respectively, and in this case, the drive wheel and idle wheel are functionally interchangeable. (For example, any one of the wheels may be a drive wheel and the other wheel may be an idle wheel).

  The catheter advancement device according to the present invention offers many advantages. For example, the device allows a clinician to place the device on a needle, such as an introducer needle, and then insert the needle into a patient, using the needle in the body to allow the clinician to move the needle The catheter can be advanced to the target position without movement. The device also forms a liquid pool at the target location by attaching the device to the proximal end of the catheter (without having to slide the device over the needle) and using the device for more controlled catheter advancement. Assist the clinician in certain procedures such as

  Hereinafter, aspects of the present invention will be described in more detail with reference to specific embodiments illustrated in the drawings.

1 is a perspective view of an exemplary catheter advancement device according to aspects of the present invention. FIG. FIG. 2 is a top view of the device of FIG. FIG. 2 is a top view of the device of FIG. 1 with the upper panel member removed. FIG. 6 is a perspective view of an alternative embodiment of a catheter advancement device according to aspects of the present invention. FIG. 6 is a top view of another embodiment of a catheter advancement device. FIG. 6 is a cross-sectional view taken along a line of the device of FIG. FIG. 6 is a cross-sectional view of an alternative nip device that may be used in a device according to aspects of the present invention.

  The invention will now be described in more detail with reference to one or more embodiments of the invention illustrated in the drawings. Each of the examples and embodiments is presented to illustrate the invention and is not intended to limit the invention. For example, features illustrated or described as part of one embodiment can be used with other embodiments to create yet another embodiment. The present invention is intended to encompass these and other modifications and variations without departing from the scope and spirit of the present invention.

  The terms “proximal” and “distal” are used herein to define the orientation of the various components relative to each other and to the patient. “Distal” refers to the direction closer to the wound site (eg, the distal end of the device is the end towards the catheter insertion site) and “proximal” refers to the opposite direction (eg, The catheter is inserted into the proximal end of the device).

  Referring to FIG. 1, one embodiment of a catheter advancement device 10 according to aspects of the present invention is shown. Device 10 includes a housing 14 that may have any design, shape, size or form, and may include any number of independent housing components. The rectangular shaped housing having a plurality of edges 24 in FIG. 1 is shown for illustrative purposes only.

  The housing 14 has a catheter inlet 16 and a catheter outlet 18, and a catheter 12, such as an infusion catheter used in nerve block procedures, is directed into the inlet 16 and passed through the housing and out of the outlet 18. As shown in FIG. 1, the catheter 12 exiting the outlet 18 is inserted into the proximal end of the needle 13.

  Device 10 includes a drive mechanism 28 that is operated with a manual finger. In the embodiment shown in FIGS. 1-7, a finger operated drive mechanism 28 is operatively provided between the catheter inlet 16 and the catheter outlet 18. The drive mechanism 28 frictionally engages the catheter 12 inserted through the housing 14 and the clinician manipulates the catheter through the housing 14 by manipulating the drive mechanism 28 with one finger (which may be the clinician's thumb). Be able to advance in either direction. Some embodiments of the drive mechanism 28 will be described in more detail later.

  The housing 14 further includes a channel 30 configured to pass the needle 13 therethrough. In the embodiment shown in FIG. 1, the channel 30 is defined by a tunnel-like member provided along the edge 24 and separated by an edge recess 26 and axially spaced. In other embodiments, the needle channel 30 may be defined by one structure, such as in the configuration of FIGS. In this specification, the term “channel” is used to encompass any type of structure that receives the needle 13 and slidably accommodates the housing 14.

  Device 10 may also include any suitable type of locking mechanism 32 operably provided in housing 14 to secure the housing in a desired position relative to the needle. This capability may be necessary in certain medical procedures where the length of the needle inserted into the patient is varied depending on any number of factors such as the patient's physiological condition, target site, and the like. When the housing 14 is secured in place on the needle 13 by the locking mechanism 32, the clinician places the device 10 in a fixed position on the introducer needle 13 and does not move by manipulating the needle 13 with one hand. At the same time, the catheter 12 can be advanced through the needle 13 with the same hand.

  The locking mechanism 32 can be any suitable mechanical or friction brake type lock that serves to secure the housing 14 in position along the needle 13. In the embodiment shown in FIGS. 4 and 5, the locking mechanism 32 is constituted by a set screw 36 that engages the needle 13 when fastened. In the alternative embodiment shown in FIGS. 1-3, the locking mechanism is constituted by a biased lever or arm 34 disposed in the recess 26 between the components of the channel 30. The arm is biased to at least partially enter the passage defined by the channel 30 so as to frictionally engage the needle 13 inserted through the component 30. The arm 34 creates a sufficient frictional resistance to prevent unintentional slipping of the housing 14 against the needle 13. This particular embodiment provides a passive locking mechanism in that the clinician does not need to move or set the lock. This locking mechanism is always engaged by the frictional resistance between the needle 13 and the arm 34.

  The drive mechanism 28 operated by a finger can have a variety of different configurations. In the particular embodiment shown in FIG. 3, the drive mechanism 28 includes a nip drive through which the catheter 12 is inserted into a nip defined between a drive wheel and an opposing support surface that may be a stationary surface. 38. In the illustrated embodiment, the support surface is a freely rotatable idler wheel 42. Drive wheel 40 and idler wheel 42 are rotatably mounted within housing 14 by any suitable bearing structure. The drive wheel 40 is a member that is manually moved by the clinician's fingers or by other members.

  In the embodiment of FIGS. 1-3, the housing 14 includes a rear panel member 22 opposite the front panel member 20, and the front and rear panel-like members each extend on mutually parallel planes. It can be a configuration. The nip drive unit 38 includes a drive wheel and an idle wheel disposed between the front panel member 20 and the rear panel member 22, and these wheels are disposed on a common plane, and the front panel member and the rear panel member are arranged. With the axis of rotation perpendicular to. This configuration of device 10 provides a thin, compact and efficient design that is easily manipulated and controlled by a clinician.

  The nip drive unit 38 may also include a first external finger operation plate 44 attached to the drive wheel 40 through the front panel member 20. In this manner, the finger operation plate 44 extends from one of the panel members to the outside so that the drive wheel 40 can be easily accessed from the outside and can be manually operated. In a further embodiment shown in FIGS. 1, 3, and 4, a second external finger operation plate 46 is attached to the drive wheel on the opposite side of the housing 14 from the first external finger operation plate 44. 14 is configured to be substantially sandwiched between both finger operation plates 44 and 46. In this configuration, the drive wheel 40 can be controlled from either side of the housing 14. As shown, one or both of the finger manipulating plates 44, 46 extend radially beyond the edge 24 of the housing 14 and is driven by the clinician moving the finger along the edge 24 of the housing. It may be beneficial to configure to also have the option of controlling the wheel 40.

  5-7 show an alternative embodiment, in which the drive wheel 40 and idle wheel 42 are at least partially disposed inside the parallel front panel member 20 and rear panel member 22, both panel members. Can be configured to have a rotation axis parallel to the axis. As readily understood from FIGS. 5 and 6, the outer peripheral portion of the drive wheel extends outwardly through one of the front panel member 20 or the rear panel member 22, and the clinician places a finger along each panel member. The drive wheel is configured to be manually operated by being slid and engaged with the drive wheel 40. In the embodiment of FIG. 6, the idler wheel is fully contained within the housing 14 and the drive wheel 40 is exposed through the front panel member 20. For example, in the alternative embodiment shown in FIG. 7, the outer peripheral portions of the drive wheel 40 and idle wheel 42 extend outward through the front panel member 20 and the rear panel member 22, respectively. Therefore, in this embodiment, the drive wheel 40 and the idle wheel 42 are functionally interchangeable (for example, any one wheel may be a drive wheel and the other wheel may be an idle wheel).

  It should be understood that the device 10 can be utilized in certain procedures without attaching the device to a needle. For example, the device 10 can simply be used as a means for advancing the catheter in a more controlled manner to move the catheter in and out of the patient, for example by injecting liquid through the catheter to the target location. While the catheter is advanced or retracted when forming the liquid pool, this catheter movement can be done without having to attach device 10 to the needle.

  Although the invention has been described in connection with specific preferred embodiments, it is to be understood that the inventive subject matter encompassed by the invention is not limited to these specific embodiments. Rather, the subject matter of the invention is intended to embrace all such alternatives, modifications and equivalents that fall within the scope and spirit of the claims.

Claims (13)

A catheter advancement device,
A housing having a catheter inlet and a catheter outlet;
A manually operated finger operated drive mechanism provided between the catheter inlet and the catheter outlet;
The catheter advancement device wherein the drive mechanism frictionally engages a catheter inserted into the housing and advances the catheter through the housing. A catheter advancement device according to claim 1,
The housing further includes a channel and a locking mechanism;
The catheter advancement device characterized in that the housing can be slidably positioned along a needle inserted into the channel and can be locked to a fixed relative position on the needle by the locking mechanism. A catheter advancement device according to claim 2,
A catheter advancement device, wherein the channel is provided along an edge of the housing. A catheter advancement device according to claim 3,
The locking mechanism includes a biased arm disposed along the channel to frictionally engage the needle and to fix the relative position of the needle to the housing. Catheter advancement device. A catheter advancement device according to claim 1,
A catheter advancement device, wherein the drive mechanism includes a nip drive having a finger operated drive wheel. A catheter advancement device according to claim 5,
The catheter advancement device, wherein the nip drive unit further includes an idler wheel facing the drive wheel. A catheter advancement device according to claim 6 comprising:
The housing includes a front member and a rear member opposite to the front member, and the front member and the rear member respectively extend on mutually parallel planes,
The catheter advancement device, wherein the drive wheel and the idler wheel are disposed between the front member and the rear member, and have a rotation axis perpendicular to the front member and the rear member. . A catheter advancement device according to claim 7,
A catheter advancement device further comprising a first external finger manipulation plate attached to the drive wheel for manual operation of the drive wheel. A catheter advancement device according to claim 8 comprising:
The catheter advancement device further comprising a second external finger manipulation plate attached to the drive wheel on the opposite side of the housing from the first external finger manipulation plate. A catheter advancement device according to claim 9,
A catheter advancement device, wherein at least one of the first external finger manipulation plate and the second external finger manipulation plate extends radially beyond an edge of the housing. A catheter advancement device according to claim 6 comprising:
The housing includes a front member and a rear member opposite to the front member, and the front member and the rear member respectively extend on mutually parallel planes,
The drive wheel and the idle wheel are disposed at least partially between the front member and the rear member, and have a rotation axis parallel to the front member and the rear member. A catheter advancement device. A catheter advancement device according to claim 11, comprising:
The catheter advancement device, wherein an outer peripheral portion of the drive wheel extends to the outside through the front member or the rear member for manual operation of the drive wheel. A catheter advancement device according to claim 11, comprising:
An outer peripheral portion of each of the drive wheel and the idle wheel extends to the outside via one of the front member and the rear member, respectively, and the drive wheel and the idle wheel are functionally interchangeable. A catheter advancement device.

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